Joan Budden looks at 2019 as a year to keep pushing for greater affordability and accessibility in health care. The president and CEO of Grand Rapids-based health plan Priority Health welcomes the greater attention and scrutiny that arose in 2018 for prescription drug costs that are becoming a major cost burden for health insurers and employers. She expects the trend to greater price transparency and consumerism to further take hold for the industry in 2019.

Mary Free Bed Rehabilitation Hospital goes into 2019 with a new partner after signing a collaboration agreement in November with Spectrum Health to work together on research and coordinating patient care. The Grand Rapids rehabilitation hospital also formalized a research partnership with the University of Michigan Health System, and toward year’s end acquired the in-home skilled nursing services unit from Sunset Retirement Communities and Services. Looking ahead to 2019, President and CEO Kent Riddle sees a continuation of the high growth that Mary Free Bed has experienced in recent years since forming a statewide care network.

For this Crystal Ball edition of MiBiz, our team of journalists spoke with dozens of executives across West Michigan about their outlook for 2019. From those conversations, we’ve subjectively boiled down their concerns into this list. The first three issues certainly rank as their major concerns, while the rest of the list were their main worries that rose to the forefront.

Whether the West Michigan manufacturing industry continues on an ongoing growth trend in 2019 or veers into a contraction remains uncertain. Economist Paul Isely, associate dean for undergraduate programs in the Seidman College of Business at Grand Valley State University, uses automotive, furniture, agriculture, and “amazingly nowadays” aerospace manufacturing to find the pulse of where the region’s economy is headed in the coming months and years.

West Michigan-based manufacturing executives think 2019 marks a good time to take a pause from the recent breakneck pace of capital investments and acquisitions to focus on operations. That’s the general consensus from local manufacturing leaders across a range of industries who participated in a forward-looking roundtable discussion with MiBiz earlier this month.

West Michigan manufacturers are dealing with a host of issues, ranging from trade and tariffs to talent and technology. As they wade through those challenges, the Michigan Manufacturing Technology Center-West is there to help, according to Regional Director Justine Burdette. As MMTC seeks to “maintain that closeness and relationships with our manufacturers,” the organization is finding new ways to adapt and address their needs, she said.

Cascade Die Casting Group Inc. is a manufacturer heavily concentrated in the automotive industry. Although the company recently lost business related to the closure of several General Motors plants, the industry shift from low price-point cars to higher-margin trucks and SUVs has President Patrick Greene cautiously optimistic about continued growth in 2019.

This year, unemployment rates have dropped to an 18-year low and local manufacturers are scrambling to find new and innovative ways to grow without gaps. As founder of the advisory firm 100X LLC and chair of Vistage Executive Peer Group, an executive coaching organization, former manufacturing exec Steve Johandes helps dozens of local organizations and companies position themselves for “what’s next” in the market.

Women are critical to addressing the serious shortage of qualified applicants for skilled production positions, according to Kelly Springer, CEO of Metal Flow Corp., a Holland-based automotive supplier. Yet, relatively few women choose manufacturing careers. As chair of Inforum’s ManufacturingNext steering committee, Springer is helping to strengthen the talent pipeline of women who thrive in manufacturing professions.